The shift in clinical practice towards the ambulatory setting has made outpatient followup to hospitalization necessary for optimal patient management. Surprisingly little is known about this. In an over- burdened public hospital system, requiring patients to make appointments with chronically overbooked clinics may result in "rationing by queuing". This prospective, observational study focuses on compliance with hospitalization followup appointments and has the following objectives: (1) Assess determinants of compliance with physician recommended followup appointments after hospitalization in an inner city public teaching hospital. Specifically, to elucidate associations between patient related factors, barriers to health care access and followup compliance. (2) Investigate system obstacles to patients leaving the hospital with a specific appointment date and time in hand. (3) Explore medical consequences of failure to keep followup appointments by studying associations between appointment compliance and hospital readmission rate, emergency department visit frequency and mortality. Based on pilot data, this study will test the following hypotheses: (a) among the medically indigent, copayment requirement at time of clinic followup is negatively associated with appointment compliance; and (b) compliance with followup appointment recommendations is positively associated with patients leaving the hospital with a specific return date, time and place in hand. Approximately 450 consecutive patients will be interviewed on hospitalization; followup arrangements will be recorded shortly after discharge from hospitalization. Patients missing their first followup appointment will be contacted. Clinic and emergency department visit and rehospitalization rates will be ascertained by computerized database searches for all patients. Multivariable techniques will be used in data analysis. This study will create a foundation for research on interventions to improve patient care through coordination between inpatient and ambulatory services.